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Governance and Accountability

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As the first and only provincial First Nations Health Authority in Canada, FNHA is committed to meeting high operational standards as defined by BC First Nations and our government partners. We are committed to being accountable, transparent and to continuously improving our operations.  

Each year, we publish Annual Reports which include independently audited financial statements. We are pleased to share these reports available here. ​

​The FNHA has documented our work extensively along our journey. In addition to publishing multiple Annual Reports each year, we also publish Summary Service Plans that include budget forcasts and Transition Bulletins to mark our journey - these items are available on our Transition and Transformation page here. 

We seek to inform BC First Nations communities and leadership, our partners and other First Nations communities across the country of why, how and what work we are engaged in.​ This has included a documentary book for the Assembly of First Nations, and numerous communiques and press releases available in our media section.

First Nations Health Governance Placemat

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Download a PDF version here. (759 kb)

The First Nations Health Governance PlaceMat describes the roles and  responsibilities that each of us bring to our Made in BC First Nations Health Governance Structure and includes our approach to engagement and planning. We hope you enjoy this snapshot! ​


The First Nation​s Health Governance Structure​
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First Nations Health Governance Structure brochure (PDF 951 KB)

BC First Nations, the Province of BC, and the Government of Canada all determined that statistically significant health disparities for First Nations people in BC are no longer acceptable. 

A New Relationship between the Tripartite Partners is represented by the signing of the Transformative Change Accord (2005), the Transformative Change Accord: First Nations Health Plan​ (2006), the First Nations Health Plan Memorandum of Understanding (2006), the Tripartite First Nations Health Plan (2007), the Basis for a Framework Agreement on First Nation Health Governance (2010) and the British Columbia Tripartite Framework Agreement on First Nation Health Governance (2011). 

With each of these Agreements, the partnership has grown, developed, and evolved. Over time, the Partners have recognized how to better work with one another – to make adjustments and accommodations to be better Partners.

The signing of the British Columbia Tripartite Framework Agreement on First Nations Health Governance on October 13, 2011, changed the course of First Nations health in BC with the creation of a new First Nations Health Governance Structure that will enable First Nations in BC to participate fully in the design and delivery of these services. 

Decision-making will be brought closer to home through recognizing and involving First Nations decision-making and service delivery processes, structures, and institutions at provincial, regional and local levels. In particular, the Partners will nurture the partnerships between First Nations in all regions and each provincial Regional Health Authorities.

BC First Nations Chiefs overwhelmingly endorsed the Framework Agreement, voting for greater control by BC First Nations over their own health care. This was a key milestone in the 10-year Tripartite First Nations Health Plan signed in 2007.

The British Columbia First Nations Health Governance Structure includes four components:

  • The First Nations Health Authority (FNHA): responsible for planning, management, service delivery and funding of health programs, previously​ provided by Health Canada's First Nations Inuit Health Branch Pacific Region.

  • The First Nations Health Council (FNHC): provides political leadership for implementation of Tripartite commitments and supports health priorities for BC First Nations.

  • The First Nations Health Directors Association (FNHDA): composed of health directors and managers working in First Nations communities. Supports education, knowledge transfer, professional development and best practices for health directors and managers. Acts as a technical advisory body to the FNHC and the FNHA on research, policy, program planning and design, and the implementation of the Health Plans.

The Tripartite Committee on First Nations Health (TCFNH)​​: the forum for coordinating and aligning programming and planning efforts between the FNHA, BC Regional and Provincial Health Authorities, the BC Ministry of Health, and Health Canada Partners.

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The relationship between the FNHA, FNHC, and FNHDA is represented in the 2012 Relationship Agreement which outlines the sound partnership sought by the Parties – a partnership based on shared values and understanding of our collective and respective roles, responsibilities, and accountabilities.​

The partnership between the FNHC, FNHA and FNHDA is directed and mandated by BC First Nations through the following governing documents: 

Tripartite First Nations Health Plan

Resolution 2011-01 and the Consensus Paper 2011: BC First Nations Perspectives on a New Health Governance Arrangement

British Columbia Tripartite Framework Agreement on First Nation Health Governance

Resolution 2012-01 and the Consensus Paper 2012: Navigating the Currents of Change Transitioning to a New First Nations Health Governance Structure

"The Parties recognize that achieving this outcome while upholding the 7 Directives adopted by BC First Nations requires coordination, cooperation, and a shared understanding. The Parties further recognize that the strength of our work arises from a collective voice amongst us. 

This partnership is based on shared values and understanding of our collective and respective roles, responsibilities, and accountabilities. The 2012 Relationship Agreement defines those roles, responsibilities and accountabilities that create and maintain an ethical and productive partnership between us and is written in the spirit of the shared values upon which our partnership is based."

2012 FNHA, FNHC, FNHDA R​elationship Agreement​

Read more:

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